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I Never Knew that Swallowing Could Be So Complicated

Posted Oct 23 2012 2:00pm

I should have noticed the red flag—coughing and choking when eating and drinking during meals. I was clueless. I simply avoided dealing with it, thinking I already had too many other issues on my Parkinson’s plate. I recently discovered that have been experiencing difficulty swallowing (dysphagia).

Estimates of dysphagia’s prevalence in Parkinson’s Disease run as high as 90 percent. But how do you know if and when swallowing becomes a problem? The National Parkinson Foundation ( www.parkinson.org ) has a  highly informative booklet, Parkinson Disease: Speech and Swallowing, 2nd Edition written by Marjorie L. Johnson, MA, CCC-SLP. Included in the booklet is a self-assessment checklist that helps you determine if you may have a swallowing problem. Their checklist below is a good place to start. Check all that apply.

Swallowing Checklist for Persons with Parkinson’s Disease

I have recently lost weight without trying.

I tend to avoid drinking liquids.

I get the sensation of food being stuck in my throat.

I tend to drool.

I notice food collecting around my gum line.

I tend to cough or choke before, during, or after eating or drinking.

I often have heartburn or a sore throat.

I have trouble moving food to the back of my mouth.

I have trouble keeping food or liquid in my mouth.

It takes me a long time to eat a meal.

I sometimes have trouble swallowing pills.

My eating habits have changed recently, and/or I have a loss of appetite.

SometimesI have fever for unexplained reasons.

I notice changes in my voice quality after eating or drinking.

If you checked any of the boxes above, you may need to get a referral from your doctor to see a speech-language pathologist (SLP) for a swallowing assessment.

And if you are really brave, you may want to ask your care partner to complete the following checklist and check all the statements that apply.

Swallowing Checklist for Care Partners of Persons with Parkinson’s Disease

She/he seems uninterested in food.

She/he coughs or gets “strangled” during meals.

She/he often coughs following a meal when we are doing other activities such as watching TV or reading.

I have had to use the Heimlich Maneuver on the person that I am helping.

If the care partner checks any of the above statements, it is important to encourage the person with Parkinson’s to get a referral from the doctor for a swallowing evaluation by a SLP.

By completing the checklists, you and your care partner have taken the first step toward recognizing, understanding and getting help for your swallowing difficulties. Be proactive--don’t let a swallowing problem turn into a life-threatening event.

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